Clinical Laboratory Information
Similar CLIA Codes
|
|
CLIA Number
|
04D0675785
|
|
Clinical laboratory number
|
|
Lab Name
|
LAKE FOREST SENIOR LIVING, MOUNTAIN HOME
|
|
Laboratory Name
|
|
Lab Type
|
Skilled Nursing Facility/Nursing Facility
|
|
Laboratory Type
|
|
Certificate Type
|
Waiver
|
|
Clinical laboratory certificate type
|
Contacts |
|
Phone
|
870-425-2494
|
|
Laboratory telephone number
|
|
Fax
|
870-404-2036
|
|
Fax number of the provider.
|
Facility Location |
|
Street Address
|
300 GOOD SAMARITAN DRIVE
|
|
Primary location adress line
|
|
City
|
MOUNTAIN HOME
|
|
Primary location city name
|
|
State
|
AR
|
|
Primary location state name
|
|
Zip
|
72653
|
|
Primary location postal code
|